The bill aims to protect health care consumers from surprise billing by amending various sections of the General Laws. It introduces new definitions, such as "facility fee" and "surprise bill," and establishes regulations regarding the charging of facility fees by health care providers. Specifically, health care providers are prohibited from charging facility fees unless the services are provided on a hospital campus, at a licensed emergency department, or in certain emergency situations. Additionally, the bill mandates that patients must receive written notice of any facility fees prior to receiving services, with specific timelines for notification based on the scheduling of appointments.

Furthermore, the bill outlines the responsibilities of health care providers in notifying patients about their participation in health benefit plans and the implications of receiving services from out-of-network providers. It also establishes penalties for non-compliance and allows the Attorney General to investigate violations. The bill includes provisions for reimbursement rates for out-of-network services and ensures that patients are only responsible for in-network cost-sharing amounts when receiving unforeseen out-of-network services. Overall, the legislation seeks to enhance transparency and protect consumers from unexpected medical bills.

Statutes affected:
Bill Text: 175H-1